For patients with extensive-stage small cell lung cancer (SCLC), cytotoxic chemotherapy remains a mainstay of treatment. However, myelosuppressive hematologic adverse events such as anemia, neutropenia, and thrombocytopenia pose a significant challenge to care. In a study recently presented at the 63rd American Society of Hematology (ASH) Annual Meeting & Exposition in Atlanta, Georgia, a team of researchers led by Dr. Jerome Goldschmidt, medical oncologist at Blue Ridge Cancer Care and the US Oncology Network, found that patients with extensive-stage SCLC who developed myelosuppressive hematologic adverse events experienced more dose reductions, treatment delays, and health care resource utilization than those who did not experience events. In this interview, Dr. Goldschmidt discusses the significance of these results.
Oncology Data Advisor: What is the background of your research regarding hematologic adverse events in patients receiving myelosuppressive chemotherapy for SCLC?
Jerome Goldschmidt, MD: Our abstract at ASH looked at hematologic adverse events associated with myelosuppression in SCLC. Our team analyzed about 1,400 patients extracted from our electronic medical records. We generated some real-world evidence to show the burden of myelosuppression and the associated health care utilization. We talk a lot about saving money in health care these days, so this research is trying to get to the bottom of health care savings—that's really the gist of this abstract.
Oncology Data Advisor: Can you explain the significance of your results?
Dr. Goldschmidt: In a nutshell, we looked at 1,400 patients extracted from the US Oncology Network iKnowMed database. We looked at patients with extensive-stage SCLC specifically, because they are primarily treated with myelosuppressive chemotherapy, even in this day and age in 2022. We found that almost 800 of these patients experienced serious grade ≥3 hematologic adverse events. That translated into a significant burden on these patients, meaning that they received transfusions more preferentially. These patients also had more hospitalizations and required more utilization of granulocyte-colony stimulating factor and other supportive care medications.
This is what we captured in the outpatient setting; we did not capture data in the inpatient setting. Nonetheless, even by just looking at outpatient data, we were able to see that a patient with extensive-stage SCLC who receives myelosuppressive chemotherapy—mainly in the form of carboplatin or etoposide—has about an $8,000 to $9,000 difference in their cost of care compared with a patient who does not experience a grade ≥3 hematologic adverse event. It adds a significantly greater cost to their care—and that's just for an outpatient.
Oncology Data Advisor: What are the future steps for this research?
Dr. Goldschmidt: We think that there are better management strategies that can be employed in the future. There may be better pharmaceuticals out there, that are either in existence or are emerging, that can help prevent some of this burden on patients with extensive-stage SCLC. Hopefully this research will also translate to other types of cancer with requirements for myelosuppressive chemotherapy, such as breast cancer, lymphomas, non–small cell lung cancer, and others.
About Dr. Goldschmidt
Jerome Goldschmidt, MD, is a medical oncologist at Blue Ridge Cancer Care in Blacksburg, Virginia, and an adjunct faculty member at Virginia College of Osteopathic Medicine. He specializes in the treatment of patients with cancer, and his areas of focus include cancer survivorship, clinical research, and cancer prevention.
For More Information
Goldschmidt J, Monnette A, Shi P, et al (2021). Understanding hematological adverse event management through health care resource utilization, costs, and treatment patterns of patients with extensive-stage small cell lung cancer treated in the community oncology setting [oral presentation]. Presented at: 63rd American Society of Hematology Annual Meeting & Exposition. Abstract 1913.
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.